Governing through care: A qualitative assessment of team play between police and nurses for people with mental illness

Abstract

The nexus between law enforcement and public health represents a new and emerging policy field. Yet, most scholarly work has been devoted to police attitudes and interventions involving people affected by mental illness. This paper draws attention to a law enforcement-public health partnership in Amsterdam, the capital city of the Netherlands. We present a qualitative study based on interviews and some observations. Three major themes emerged from our fieldwork that involved policy makers, community police officers, and district nurses: how these officers and nurses perceive the problem of disorderly and confused people, how they work together in practice, and how they relate to a wider network of many other players. We argue that community police officers and district nurses have developed a kind of informal 'team play' consisting of three steps: receiving and analysing a signal, undertaking action, and providing aftercare. These steps offer a preventative approach aimed at avoiding and forestalling crisis situations. Difficulties arise in terms of tracing so-called 'care avoiders' (people who do not present a 'readiness for treatment'), hampered information exchange, and the governance of partners beyond our respondents' own organisations. In particular, we argue that today's society is not only governed through crime, but also through care. There is no such thing as a robust 'punitive complex' in which policing and criminal justice logics prevail. Rather, we witness a multi-agency network of police, public health, mental health, youth care housing associations and other nodal actors, each with their own bureaucratic logics and working methods tending to clash with, or even undermine, informal team play on the streets.

Subjective experiences of the first response to mental health crises in the community: a qualitative systematic review

“…Mental health crises will often take place in a person’s home with others, often family, present. In line with research of parents of children with psychosis,87 companions described the, often traumatic, impact of the FR response and a lack of inclusion and communication 18 24–30 33–37 39–41 43–60 62–70 74–78 81 82 86 88–104. Our findings reflect that of previous studies,105 which show that family/carers experience distress, guilt, reluctance to call FRs, fear of disproportionate use of force and relief for having FR support.…”

“…FRs felt unequipped to respond to MHC due to their lack of knowledge, resources and time constraints25–27 31 34 37 40 44 45 52–54 56 57 63 64: “ training makes it look straight forward and it’s dead simple…and then you go out and it’s just a different game” (police officer) 45. Police described their past reluctance to ask PMI direct questions, thinking they would distress them, and instead asked vague questions that overwhelmed and confused PMI 40.…”